Closer to the Goal: Efforts in Measles Elimination in Germany 2010

Abstract

Increasing 2-dose vaccination coverage has led to an interruption of endemic measles virus circulation in Germany. However, outbreaks after virus importation still occur and contribute to international transmission chains. Between 2003 and 2009, annual measles incidence ranged between 0.2 and 2.8 per 100,000 population. Immunization gaps have been identified especially in secondary-school students and young adults, which is also reflected by a shift in age distribution of reported measles cases toward older age groups. Stronger political commitment and standardized guidelines for outbreak containment were put in place in Germany in the past years, but the last step toward measles elimination cannot be made until the number of susceptible individuals has been further reduced. In addition to routine childhood vaccination, supplementary immunization activities are needed targeting school students and young adults to close critical immunization gaps. Intensification of public awareness and sound information on vaccinations are necessary to convince skeptics and remind the forgetful.

Measles incidence and reporting trends in Germany, 2007–2011

“…These differences can be largely explained by local differences in vaccination coverage and population immunity 8 , 9 . Several possible reasons for these differences in vaccine uptake have already been discussed 22 – 25 .…”

“…In contrast, we found that measles incidence in the western area followed a constantly decreasing trend between 2007 and 2011. This encouraging trend may be associated with concerted programmes of health education and a catch-up campaign of measles vaccination, as well as the efforts to increase vaccination coverage at school entry that followed the large-scale outbreak of measles that occurred in North Rhine-Westphalia in 2006 8 . The proportion of children in North Rhine-Westphalia who had received a second dose of measles vaccine at school entry increased from 74.7% in 2005 to 94.1% in 2011 11 , 12 …”

“…In 2006, for example, more than 1500 cases were recorded in an outbreak in the federal state of North Rhine-Westphalia 5 , 6 , 7 . Historically, health-related issues in Germany – including the implementation of vaccination recommendations and measures for disease control – have been the responsibility of the country’s 16 federal states 8 . This is one of the reasons why vaccination coverage in Germany often differs between federal states.…”

Current status of measles in the Republic of Korea: an overview of case-based and seroepidemiological surveillance scheme

“…With the reduction in the number of children affected by measles, changes in the epidemiology of the disease are to be expected, as has been experienced in other countries14,15). To maintain the elimination status of measles in Korea, ongoing efforts are needed to meet the goals of: 1) high vaccination coverage for 2 doses of MMR vaccine, and 2) building effective measles surveillance strategies16,17).…”

Spread of Measles Virus D4-Hamburg, Europe, 2008–2011

“…Recent outbreaks showed an immunization gap in adolescents and young adults ( 6 ). Consequently, outbreaks still occur in Germany every year, although recently they have been more limited in number of cases, length of time, and extent of national transmission ( 7 , 8 ). A total of 915 measles cases were reported in 2008, 571 in 2009, and 780 in 2010; incidence was 7–10 cases/1 million population (www3.rki.de/SurvStat/QueryFormaspx).…”